Under a health insurance system, each medical institution sends a bill for medical fees (including medical benefits) and a specification of services performed by a medical institution to a health insurance examination center. The health insurance examination center examines the medical bill and specification to determine whether the medical fees billed by the medical institution are reasonable, and sends the examination results to the national health insurance corporation. The national health insurance corporation pays the medical fees to the medical institution based on the examination results informed from the health insurance examination center.
The health insurance examination center distributes bills and specifications submitted by medical institutions, such as special sanatoriums, general hospitals, dental clinics, herb medical hospitals or clinics, pharmacies and public health centers, to examiners and lets the examiners examine the bills and specifications and thereby determine whether the medical services offered and the medical fees billed are right and reasonable. Recently, due to the increasing number of medical institutions and a growing diversity in the kinds of diseases reported, the types of medical practice and the kinds of drugs and medications have also increased, thereby causing the examiners' ever-increasing workload in examination of medical bills and specifications. Particularly, the examiners have difficulties when examining medical bills and specifications relating to various new drugs and medications prescribed for the treatment of new kinds of diseases. Since the medical fees are paid to the medical institutions according to the examination procedure and progress in the health insurance examination center, the working efficiency of the examiners in the health insurance examination center is significant to the medical institutions. Therefore, it is highly required to improve the efficiency in examination of medical bills and specifications by the health insurance examination center.